About one-fourth of patients don't take their medications as directed, and a slew of new devices helps to give them the nudge they need.

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TUESDAY, June 12, 2012 — Lucy Hornstein, MD, a family physician in Phoenixville, Pa., says about half her patients don’t take medications as directed. Plenty of them fess up at checkups that they forget to take their pills, specially on weekends. With others, she finds out from pharmacists that her patients aren't filling their prescriptions on time.

“There are a number of reasons medication adherence can be low,” says Dr. Hornstein, who blogs about her job on Musings of a Dinosaur. “Either they don’t think they need them, or they don’t want to be taking medications and sometimes they can’t afford them.”

About 1 in 4 Americans don't take their medications as prescribed, according to the Yale Medical News Web site. Medications taken incorrectly sometimes don't work as they should or can, and can worsen your condition in ways you can't detect, such as hypertension, known as a silent killer.

Doctors can do things to spur patients to take their medications: Prescribing low-cost generics or once-a-day medications that can be taken on a regular schedule, or teaching patients to monitor their own blood pressure and glucose levels so they see how meds impact their health.

But new tools are available for harried or forgetful patients who still can't get their medication regimens straight. These options, which range from low-tech to high-tech, aren't for everyone. Finding the right one for your personality and lifestyle is key.

The Traditionalist: The regular old seven-day pill box at your local pharmacy is a low-tech way of making sure you're taking the right medicines. At the beginning of each week, organize your medications by day. Mark your calendar with the date you need to get a refill, and be sure to allow yourself some extra time in your schedule to pick up your prescription at the pharmacy or wait for home delivery. "For people with a complicated regimen, it's useful to fill a pill box once a week," Hornstein says. "Simple still works, and it doesn't cost an arm and a leg."

Scattered Swallower: For those who have to take different medications at different times a day, timekeepers such as Cadex alarm watches allow patients to set alarms to sound each time they need to take a medication. Many of these watches can program up to 12 reminders a day with optional text message prompts that include the name of the medication and its strength.

Nervous Ned: For the pill popper who is anxious about human error, there are digital medicine dispensers. These high tech pill boxes keep medications locked up until the exact time the medication needs to be taken. Some versions of digital pillboxes have an alarm that sounds until the user turns the box upside down to take out the medicine. Several models can be connected to the Internet to let a family member or doctor know if medication hasn't yet been taken.

Discreet Doser: Some of us want to keep our pill-taking private. Tiny, flat pill boxes that slip inside a shirt or pants pocket or devices like the CapsulePen, a tubular container shaped like a pen into which you load your supply of pills in the order they need to be taken, may work best. The pen, which is still in development and not yet on the market, is designed to accommodate most pill sizes, and a clip will allow users to fasten it inside a pocket. The hexagonal body and magnetized ends are designed to allow several pens to fit together in case a patient wants to keep a whole week's supply of medications together.

iPhone Addict: A number of smartphone apps cater to pill-takers who are tied to their gadgets. RxmindMe is a free app that alerts users when they need to take their medication and reminds them when they have to refill their prescriptions. It also keeps a record of medication taken that can be easily exported to other devices, and transmitted to doctors. Digital Pillbox, which costs $9.99 for a lifetime license, reminds you what pill you need to take and when you need to take it by putting a daily alarm on your phone. It takes a scattershot approach to reminding you to take your meds, including flashing lights, audible beeps, and other alert options such as phone calls, text messages, and emails. And if you respond best to visuals, you can snap photos of your pills so you can keep track of what they look like. Patients can also record dosing history to pass on to loved ones or caregivers.

Futurist: Proteus Biomedical's smart pills turn into accountability monitors when they interact with stomach acid. These pills let healthcare providers know when a patient has taken the necessary meds. Proteus says it plans to debut the pills in Europe soon, but no release date has been set in the United States.

Novel, and supposedly fool-proof methods, won't require patients to take a pill for all. For example, new technology being tested by Waltham, Mass.-based drug delivery company MicroCHIPS Inc., allows people with severe osteoporosis to receive bone-building drugs at the push of a button through an implanted microchip.

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